(Fig 3-A.47) Extra-Capsular Medial Tibial Crest Friction

https://youtu.be/Mvcy1pMse3k

https://youtu.be/GSIg93UH3Oc

 

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📌 Extra-Capsular Medial Tibial Crest Friction

✅ Clinical Presentation

• The condition is predominantly seen in young adults with a high level of physical activity, particularly athletes.
• Patients typically complain of pain and tenderness approximately 2.5 cm below the medial joint line.

✅ Imaging Findings

• It is suggested that prominence of the medial tibial crest due to a reduced medial tibial crest angle results in friction between the MCL and the adjacent bone.
• Hyperintense signal on fat-suppressed proton density-weighted fast spin-echo (PDW FSE) images at the medial tibial crest and adjacent soft tissue is observed in all patients, indicating edema occurring where the TCL contacts the proximal tibia.

✅Differential Diagnosis

• The only disorder that could probably mimic medial tibial crest friction syndrome with pain at this specific site could be pes anserine bursitis.
• However, pes anserine bursitis is located approximately 5 cm below the mid-articular line, whereas patients with medial tibial crest friction syndrome report pain 2.5 cm inferior to the knee joint space, as confirmed by clinical examination on-site, just prior to MRI examination.
• Moreover, pes anserine bursitis is typically found in obese females aged more than 50 years old.

 

Skeletal Radiology (2020) 49:823–836

Eur J Radiol. 2013 Nov;82(11):e703-6

"Visualizing MSK Radiology: A Practical Guide to Radiology Mastery"

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#MedialTibialCrestFriction, #MCLFriction, #ExtraCapsularFriction, #SportsMedicine, #AthletesInjury, #TibialCrestAnatomy